| NPI | 1861936023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302036334) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS45928) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-07 |